Individual provider Active NPI

Thomas V Robb, D.O.

  • Surgery Physician
  • Cornwall, NY
National Provider Identifier
1245327162
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
209975 Issued in NY
Practice address
21 Laurel Ave
Suite 240
Cornwall, NY 12518
Phone
(845) 534-0008
Fax
(845) 534-0018
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 209975 NY Primary

Addresses

Primary practice location

21 Laurel Ave
Suite 240
Cornwall, NY 12518

Mailing address

21 Laurel Ave
Suite 240
Cornwall, NY 12518
Phone (845) 534-0008

Other identifiers 1

IdentifierTypeStateIssuer
01818051MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000397 NY Practitioner - General Surgery 3274436050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Surgicalist Services, P.C.Group PAC ID 7911306956, 9 clinicians
Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

460 Gidney Ave
Newburgh, NY 12550-3117
Phone (845) 458-4700

70 Dubois St
Newburgh, NY 12550-4851
Phone (845) 561-4400

Hospital & facility affiliations

  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
209975NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Surgicalist Services, P.C. Surgery CurrentSince Mar 23, 2021 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgery CurrentSince Aug 1, 2015 Accepting new patients
St. Barnabas Orthopedic Surgery Practice PC Past Accepting new patients
St. Luke'S Cornwall Hospital Past Accepting new patients

Locations

19 Laurel Ave
Cornwall, NY 12518
Phone (845) 343-6368

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

407 Gidney Ave
Ste B
Newburgh, NY 12550
Phone (845) 458-4700

460 Gidney Ave
Newburgh, NY 12550
Phone (845) 458-4700

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1245327162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LAUREL AVE",
            "address_2": "SUITE 240",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "12518",
            "telephone_number": "845-534-0008",
            "fax_number": "845-534-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LAUREL AVE",
            "address_2": "SUITE 240",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "12518",
            "telephone_number": "845-534-0008",
            "fax_number": "845-534-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBB",
        "first_name": "THOMAS",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "209975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01818051",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornwall, NY

Sources for this page

Verify at the official NPI Registry.